Relations between Washington and Beijing are said to be worse than at any point since their normalization in 1979, and they are on the verge of plunging further through a “trade war” over the horizon, military tensions over the South China Sea and Taiwan where past management is being challenged, exposure of the illusion of a comprehensive agreement on North Korea now that diplomacy is being pursued, and even an ideological competition reminiscent of the Cold War. This Special Forum explores four approaches to the troubled relationship in search of greater clarity on what is transpiring and whether it can be reversed. Certain challenges have deep roots. Others are seen as resulting from the leadership of Donald Trump and Xi Jinping. In some cases, limited compromises might be found, but they are unlikely to be long-lasting. With an overview of four approaches, we can strive for a broad understanding of the recent tensions.